A recent report by the BBC has highlighted the perilous situation that many cancer patients face whilst waiting to undergo their treatment. This particular story involves a terminal cancer patient attending hospital for her chemotherapy and how her and her family describe waiting in a crowded room in A&E as like a “death sentence”.

Despite having a terminal diagnosis and requiring specialist intervention, many patients find themselves caught in the bottleneck of emergency care when attending hospitals for their scheduled treatment.

Instead of being fast-tracked to a ward or a specialist oncology unit, some will spend a prolonged period in a waiting room, surrounded by the noise and chaos typical of a busy hospital department, but more so where the risk of picking up something as simple as a common cold, could prove fatal.

Across the country, "trolley waits" and long delays in A&E have regrettably become a feature of the NHS landscape. However, for a patient with terminal cancer, the "wait" is not just about discomfort—it is about the preciousness of time and the increased risk that surrounded by patients who are unwell may pose.

The clinical risks

From a patient safety perspective, placing a terminal cancer patient in a general A&E setting for an extended period creates several clinical risks:

• Infection control: cancer patients, particularly those undergoing chemotherapy or advanced treatment, often have suppressed immune systems. A busy A&E waiting room is a high-risk environment for exposure to viruses and bacteria.

• Pain management: specialist palliative care requires precise medication schedules. Delays in admission can lead to gaps in pain relief, causing unnecessary physical and emotional distress.

• Psychological impact: the stress of a long wait in an uncertain environment can be overwhelming for someone already dealing with the terminal nature of their illness.

Patient safety

When a hospital is aware of a patient's terminal status and their specific medical needs, there should be an expectation that a clear pathway to treatment is in place.

Resourcing and financing will no doubt play a part in what a healthcare provider can facilitate, but sometimes the simplest solution is often the best.

Delia Lodge, who is highlighted in the BBC story, is calling on the Ysbyty Glan Clwyd Hospital in Wales (where she attends for her treatment) to turn one of its 24 treatment rooms into a “cancer patient only wating area”, to minimise the risk of exposure and infection transmission. As she states, “Every patient, especially those with cancer, should feel safe when they come to the hospital."

What steps can patients and carers take

Whilst we hope that the system works perfectly for everyone, it is important for patients and their families to know what practical steps they can take if they find themselves in this position.

1. Find out if your hospital has an Acute Oncology Team: some major hospitals have a specialist Acute Oncology Service (AOS), so you may be able to bypass A&E.

2. Keep a "Patient Passport: carry a brief summary of your diagnosis, current medications, and the names of the lead consultant or specialist nurse. This can speed up the triage process significantly.

3. Utilise any 24-Hour Advice Lines: some oncology departments provide a 24-hour contact number. Call them before heading to A&E. They may be able to arrange a direct admission to a specific ward, bypassing the emergency department entirely.

4. Speak with PALS: if you feel the wait is becoming unsafe, ask to speak with a representative from the Patient Advice and Liaison Service. They are there to help advocate your concerns.

Of course, resources and funding are vital factors in what the NHS can realistically provide, but it is hoped that hospitals will do all they can to take into consideration the best way to facilitate any adaptations that could alleviate the legitimate anxieties of vulnerable patients.